Spinal tuberculosis: A review
- 1 September 2011
- journal article
- review article
- Published by Taylor & Francis Ltd in The Journal of Spinal Cord Medicine
- Vol. 34 (5), 440-454
- https://doi.org/10.1179/2045772311y.0000000023
Abstract
Spinal tuberculosis is a destructive form of tuberculosis. It accounts for approximately half of all cases of musculoskeletal tuberculosis. Spinal tuberculosis is more common in children and young adults. The incidence of spinal tuberculosis is increasing in developed nations. Genetic susceptibility to spinal tuberculosis has recently been demonstrated. Characteristically, there is destruction of the intervertebral disk space and the adjacent vertebral bodies, collapse of the spinal elements, and anterior wedging leading to kyphosis and gibbus formation. The thoracic region of vertebral column is most frequently affected. Formation of a 'cold' abscess around the lesion is another characteristic feature. The incidence of multi-level noncontiguous vertebral tuberculosis occurs more frequently than previously recognized. Common clinical manifestations include constitutional symptoms, back pain, spinal tenderness, paraplegia, and spinal deformities. For the diagnosis of spinal tuberculosis magnetic resonance imaging is more sensitive imaging technique than x-ray and more specific than computed tomography. Magnetic resonance imaging frequently demonstrates involvement of the vertebral bodies on either side of the disk, disk destruction, cold abscess, vertebral collapse, and presence of vertebral column deformities. Neuroimaging-guided needle biopsy from the affected site in the center of the vertebral body is the gold standard technique for early histopathological diagnosis. Antituberculous treatment remains the cornerstone of treatment. Surgery may be required in selected cases, e.g. large abscess formation, severe kyphosis, an evolving neurological deficit, or lack of response to medical treatment. With early diagnosis and early treatment, prognosis is generally good.Keywords
This publication has 114 references indexed in Scilit:
- Expert’s comment concerning Grand Rounds case entitled “Posterior listhesis of a lumbar vertebra in spinal tuberculosis” (by Matthew A. Kirkman and Krishnamurthy Sridhar)European Spine Journal, 2010
- HIV Infection–Related Tuberculosis: Clinical Manifestations and TreatmentClinical Infectious Diseases, 2010
- Noncontiguous spinal tuberculosis: incidence and managementEuropean Spine Journal, 2009
- Measurement of the concentration of three antituberculosis drugs in the focus of spinal tuberculosisEuropean Spine Journal, 2008
- The role of polymerase chain reaction in the management of osteoarticular tuberculosisInternational Orthopaedics, 2007
- Epidemiology of vertebral osteomyelitis (VO) in France: analysis of hospital-discharge data 2002–2003Epidemiology and Infection, 2007
- Musculoskeletal Tuberculosis in Bradford – A 6-Year ReviewThe Annals of The Royal College of Surgeons of England, 2007
- A new classification and guide for surgical treatment of spinal tuberculosisInternational Orthopaedics, 2007
- Complications of pedicle screws in lumbar and lumbosacral fusions in 105 consecutive primary operationsEuropean Spine Journal, 2002
- Bone scintigraphy in tuberculous spondylodiscitisEuropean Spine Journal, 1999